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Our Best Shot At Immunization Success: Winning Over The Community

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With India having crossed five years of being polio-free this year, looking back at some of the important milestones brings back memories -- some very happy and many that helped us learn and move ahead. As soldiers in the war against polio, while in the thick of battle, the focus was to concentrate on pursuing and wiping out the enemy.

The polio campaign was initiated by Global Polio Eradication Initiativein 1998.While the government of India and its many partners deserve credit for making India polio free, the community also played a major role in this success.Different levels of the government and its partners made a tremendous effort to understand the community, identify the hindrances, and address them by reaching out to the people with appropriate communication tools.

It was the willingness of the community to fight against the virus that was key in achieving a polio-free India.


The long and arduous journey began with the critical challenge of getting the public to understand the importance and impact of vaccinating their children against polio. It is a reality that, even today, there are communities that do not recognize the benefits of immunization. There are many reasons for this -- illiteracy, misguided beliefs, social norms, cultural sentiments, gender barriers and women not being allowed to interact with anybody other than family members. Over the years, the polio programme evolved as such key factors were identified and addressed by developing new, effective communication strategies and tools, which were then implemented with one aim -- to reassure families that polio vaccination would ensure a better life for their children.

It was the willingness of the community to fight against the virus that was key in achieving a polio-free India. We have come a long, long way from situations such as the case of a father who worked in a factory in Delhi, and went all the way to his village in Western Uttar Pradesh just to ensure that his daughter was not vaccinated. It took rounds of negotiations, with the polio team finally approaching local people and influencers -- people who had a direct relationship with him and his family -- to help convince him. They resolved the issue and the child was vaccinated.

The polio teams learned how to deal with parents unwilling to vaccinate their children.... [tweaking] their strategy as they went along from community to community.


From such situations, the polio teams learned how to deal with parents unwilling to vaccinate their children. The vaccination teams often visited at a time when only the mother was home and the father away at work. However, mothers lacked the power to make decisions. Even though the mother is the primary caregiver, the decision to vaccinate had to be taken by the father, who was usually not present during the vaccination team'shouse visit. In response, the teams changed their approach and started to sensitize the people with the decision-making power (the fathers) with the right information. They also found that instead of the whole team approaching a family, a single person usually had a more effective interaction with them.

There are countless such situations that guided polio programme leaders to tweak their strategy as they went along from community to community. Each of these situations continue to remain relevant to those continuing to work in the field of immunization today, beyond just for polio. These are critical lessons for community-level immunization workers to learn in order to ensure that no child is denied the first real shot at a healthy life -- routine immunization. Some of their efforts set new standards for effective communication and creativity that are now widely used in other countries. India was able to eradicate polio with strategic communications and total community involvement, and this precedent should be used to help meet the current goal of 90% immunization coverage in India. To close the immunization gap. To see that every children is immunized.


The author is a communication specialist with CORE group

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